News April 2010 Issue

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In The News: April 2010

Ultrasound-Guided Cortisone Injections May Ease Hip Pain

Ultrasound-guided cortisone injections may be an effective treatment for gluteus medius tendinopathy, a painful condition caused by an injury to the tendons in the buttocks of elderly women. Medical treatment of the condition typically includes physiotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections. The study included 54 patients with gluteus medius tendinopathy. Ultrasound-guided corticosteroid injections were performed on all patients. One month after treatment, 72 percent of the patients showed a significant improvement in pain level. The advantages of ultrasound over fluoroscopy (X-ray), said the study’s authors, include its soft-tissue imaging capabilities, which allow a diagnostic study to be performed before the injection of corticosteroids. It also allows continuous monitoring of the needle position, which facilitates safe and precise injections. The study appeared in the January 2010 issue of the American Journal of Roentgenology.

Study Finds Low Mortality Risk Following Joint Replacement

The risk of postoperative mortality, or death following surgery, is low for patients undergoing a total hip or knee replacement. According to a Norwegian study published in the January 2010 issue of The Journal of Bone and Joint Surgery, the risk of early postoperative mortality was slightly increased for the first 26 days following surgery—estimated at 0.1 percent—but was negligible thereafter. The study included 81,856 osteoarthritis patients between the ages of 50 and 80 who had undergone a total knee replacement and 106,254 who had undergone a total hip replacement. The study’s authors concluded that previous studies suggesting that increased mortality exists for as long as 60 to 90 days following a knee or hip replacement may be wrong, and that the finding of very low postoperative mortality should be reassuring for patients considering such surgeries.

Opioids, Used as Prescribed, Relieve Pain with Little Addiction Risk

A new review has found that long-term use of opioids, which bind pain receptors in the spinal cord and the brain to change the way pain is perceived, is associated with significant pain relief in patients with a small risk of addiction. The review, which appeared in the January 2010 issue of The Cochrane Library, described the findings of 26 clinical studies comprising 4,893 participants. Most patients had chronic back pain following failed surgery, severe osteoarthritis, pain related to nerve damage, and previously had tried such opioids as oxycodone, morphine, and methadone. Among studies reporting abuse or addiction, only seven of 2,613 participants reportedly were addicted or took their medicine inappropriately. The findings suggest that carefully selected patients with no history of addiction and abuse, and who are compliant with their medication usage, might experience significant amounts of pain relief with a very small risk of addiction.

Yoga Reduces Blood Compounds Known to Promote Inflammation

Regularly practicing yoga may lower compounds in the blood that promote inflammation. According to a study in the January 2010 issue of Psychosomatic Medicine, women who routinely practiced yoga had lower amounts of the cytokine interleukin-6 (IL-6) in their blood. IL-6 is an important part of the body’s inflammatory response and has been implicated in heart disease, stroke, and arthritis. Researchers assembled 50 women, divided into yoga "novice" and "expert" groups, had them take psychological tests to gauge anxiety levels, asked them to perform tasks designed to increase stress, and then took blood samples. After analysis, the women labeled as "novices" had levels of the pro-inflammatory IL-6 that were 41 percent higher than those in the "expert" group. The study concluded that yoga appeared to be a simple and enjoyable way to add an intervention that might reduce risks for developing heart disease, arthritis, and other age-related diseases. Researchers also considered it an antidote for the inflexibility that comes with aging, concluding that "the stretching and exercise that comes with yoga increases a person’s flexibility—and that, in turn, allows relaxation that can lower stress."